Thursday, February 11, 2016
Please do not submit this application if you are not currently employing workers and do not wish to apply for Personal Coverage. An initial payment of $200 is required to qualify for clearances on newly-issued WCB accounts. The payment is applied against your first invoice.
Please enter 'Legal Business Name or Applicant Name' information in UPPERCASE.
A WCB representative will contact you within three to five days of receiving your application.
Fields marked with an asterisk (*) are required.
Legal Business Name or
Applicant Name (if applicable):
Operation/Trade Name (if applicable):
Please describe your business:
Website (if available):
CRA Business Number (if applicable):
Have you or this business organization ever been registered with WCB-Alberta under the above name or any other business name?:
WCB-Alberta Account Number(s):
Name on previous WCB-Alberta account:
Have you purchased this business?:
Previous Legal Business Name:
Previous WCB Account Numbers:
Previous Owner Contact Name(s):